2026 NRCME CORE EXAMS UPDATED ALL
QUESTIONS AND ANSWERS SURE A+
✔✔A 22 year-old male contracted meningococcal meningitis from his college
roommate, discharged from the hospital 3 months ago. He brings no records with him.
He is on no medications, is otherwise healthy, and his physical examination is entirely
normal. The correct determination would be: - ✔✔Obtain hospital records. If there was
no seizure activity, he must undergo a one year waiting period before he can be
qualified, if there was seizure activity, he must undergo a 5 year waiting period seizure
free and off anticonvulsant medication before he can be qualified.
✔✔You disqualified a driver due to Stage 3 hypertension. He is back today and his BP
is less than 140/90. What do you do? - ✔✔Certify for 6 months only
✔✔You certified a driver with history of stage 3 hypertension for 6 months and now he
is back for recertification. What do you do? - ✔✔fill out a new form, check recertification
and do a full physical exam
✔✔When do you issue a 3 month certificate? - ✔✔Issued for the first time a driver
exhibits stage 2 hypertension
✔✔How long is the SPE or skilled Performance evaluation certificate valid for? - ✔✔2
years
, ✔✔A 35 year-old patient presents for initial certification. He has no known medical
history. His urinalysis reveals 3+ glycosuria. Which of the following next steps is most
reasonable? - ✔✔Assign him a status of "Determination Pending" until further
evaluation by his primary care physician.
✔✔A DOT driver presents for his medical exam. On his history he advised that he
regularly takes Dextromethorphan. This should prompt the ME to do the following? -
✔✔Counsel the driver about not consuming the medication within 12 hours of driving.
✔✔During the DOT exam a driver perceives a whispered voice at 5 feet in his left ear
and 4 feet in his right ear. This is an otherwise normal/unremarkable exam. All other
aspects of his physical examination are unremarkable. As the examiner what would you
do next? - ✔✔Certify the driver for 2 years.
✔✔A driver presents for his DOT exam. On the medical history the driver notes that it
has been a month since he has smoked and has been taking Chantix to help him with
efforts. Which of the following should the medical examiner do next? - ✔✔Disqualify the
driver until it has been shown that he is no longer taking the medication and no residual
side effects are present.
✔✔What are 2 examples of sleepiness surveys? - ✔✔Epworth sleepiness scale and
Stanford sleepiness scale
✔✔What kind of brain lesions are NOT associated with an increased risk for seizures?
What is the waiting period?
What is max certification? - ✔✔Cerebellum and brainstem vascular lesions. 1 year
waiting period. Max certification 1 year
✔✔What kind of brain lesions ARE an increased risk for seizures? What is the waiting
period? What is the max certification? - ✔✔Cortical and Subcortical. 5 years waiting
period if at risk for seizures. Max certification 1 year
✔✔A driver presents for his DOT exam. He had a myocardial infarction 5 week previous
to the exam. He presents with a return to work letter from his cardiologist with no
restrictions. Testing information included revealed that the driver was able to reach 12
METS and his left ventricular ejection fraction was 65%. Based off of this information
what certification decision should be made by the examiner? - ✔✔Temporarily disqualify
the driver because the waiting period is 2 months
✔✔A driver presents for her DOT medical exam. During the exam history it is revealed
that the driver is taken Lisinopril for hypertension, Simvastatin, and Antabuse. All other
aspects of history and exam were normal. What should the examiner do next: -
✔✔Disqualify the driver.
QUESTIONS AND ANSWERS SURE A+
✔✔A 22 year-old male contracted meningococcal meningitis from his college
roommate, discharged from the hospital 3 months ago. He brings no records with him.
He is on no medications, is otherwise healthy, and his physical examination is entirely
normal. The correct determination would be: - ✔✔Obtain hospital records. If there was
no seizure activity, he must undergo a one year waiting period before he can be
qualified, if there was seizure activity, he must undergo a 5 year waiting period seizure
free and off anticonvulsant medication before he can be qualified.
✔✔You disqualified a driver due to Stage 3 hypertension. He is back today and his BP
is less than 140/90. What do you do? - ✔✔Certify for 6 months only
✔✔You certified a driver with history of stage 3 hypertension for 6 months and now he
is back for recertification. What do you do? - ✔✔fill out a new form, check recertification
and do a full physical exam
✔✔When do you issue a 3 month certificate? - ✔✔Issued for the first time a driver
exhibits stage 2 hypertension
✔✔How long is the SPE or skilled Performance evaluation certificate valid for? - ✔✔2
years
, ✔✔A 35 year-old patient presents for initial certification. He has no known medical
history. His urinalysis reveals 3+ glycosuria. Which of the following next steps is most
reasonable? - ✔✔Assign him a status of "Determination Pending" until further
evaluation by his primary care physician.
✔✔A DOT driver presents for his medical exam. On his history he advised that he
regularly takes Dextromethorphan. This should prompt the ME to do the following? -
✔✔Counsel the driver about not consuming the medication within 12 hours of driving.
✔✔During the DOT exam a driver perceives a whispered voice at 5 feet in his left ear
and 4 feet in his right ear. This is an otherwise normal/unremarkable exam. All other
aspects of his physical examination are unremarkable. As the examiner what would you
do next? - ✔✔Certify the driver for 2 years.
✔✔A driver presents for his DOT exam. On the medical history the driver notes that it
has been a month since he has smoked and has been taking Chantix to help him with
efforts. Which of the following should the medical examiner do next? - ✔✔Disqualify the
driver until it has been shown that he is no longer taking the medication and no residual
side effects are present.
✔✔What are 2 examples of sleepiness surveys? - ✔✔Epworth sleepiness scale and
Stanford sleepiness scale
✔✔What kind of brain lesions are NOT associated with an increased risk for seizures?
What is the waiting period?
What is max certification? - ✔✔Cerebellum and brainstem vascular lesions. 1 year
waiting period. Max certification 1 year
✔✔What kind of brain lesions ARE an increased risk for seizures? What is the waiting
period? What is the max certification? - ✔✔Cortical and Subcortical. 5 years waiting
period if at risk for seizures. Max certification 1 year
✔✔A driver presents for his DOT exam. He had a myocardial infarction 5 week previous
to the exam. He presents with a return to work letter from his cardiologist with no
restrictions. Testing information included revealed that the driver was able to reach 12
METS and his left ventricular ejection fraction was 65%. Based off of this information
what certification decision should be made by the examiner? - ✔✔Temporarily disqualify
the driver because the waiting period is 2 months
✔✔A driver presents for her DOT medical exam. During the exam history it is revealed
that the driver is taken Lisinopril for hypertension, Simvastatin, and Antabuse. All other
aspects of history and exam were normal. What should the examiner do next: -
✔✔Disqualify the driver.
